Maryland State Wire

Maryland Commission on Kidney Disease met  July 26.

Here is the minutes provided by the Commission:

The Public Meeting of the Commission on Kidney Disease was held on Thursday, July 26, 2018 at 4201 Patterson Avenue. Chairman, Dr. Jeremy Yospin called the meeting to order at 2:09 p.m. Commissioners Dr. Donna Hanes, Dr. Paul Segal, Dr. Nadiesda Costa, Dr. Adam Berliner, Dr. Sumeska Thavarajah, Joan Wise, RN, Denise Collins, LCSW-C, and Susan Leon, RN were also present.

Commission staff present: Eva Schwartz, Executive Director and Donna Adcock, RN, Surveyor

Commission Counsel present: Adam Malizio, AAG

MDH staff present: Brenda Petersen, RN and John Miller, RN – OHCQ Surveyors and Kim Lang,

Associate Director of Health Occupation Boards and Commissions

Guests present were:

Kelly Morgan, Greg Hoey

Joanne Seader, Davita Pam Earll, Davita

Jessica Quintilian, NKF Jamie McNeill, Bon Secours

I. Ratify Approval Of The Minutes Of The Public Session of May 3, 2018

Commissioner Wise motioned to ratify the approval of the Public Minutes from the May 3rd session. Commissioner Hanes seconded the motion and the Commission voted unanimously to ratify the approval the Minutes of the May 3, 2018 Public Session.

II. Chairman’s Report

Dr. Yospin discussed new legislation enacted July 1st regarding prescribing controlled substances including Opioids. He noted that this legislation would impact the nephrologists and dialysis facilities as some of the nephrologists also act as primary care physicians. Dr. Yospin reported on the requirements to comply with the law and need to keep patients safe. He discussed the Prescription Drug Monitoring Program (PDMP) and Continuous Readiness in Information Security Program (CRISP) programs. Discussion ensued.

III. Executive Director’s Report

• Discussion Regarding the Assigning of an Infection Control “Officer” in a Facility

Mrs. Schwartz reported on the repetitive infection control findings during facility surveys. Discussion ensued. Ms. McNeil noted that Bon Secours has a system where staff are observed and results of the observations are considered during compensation reviews.

VI. New Business

A. Kidney Disease Program

• Stats and Budget

Dr. Yospin reviewed the submitted KDP budget report.

• KDP Benefits

Mrs. Schwartz directed the guests’ attention to the attachments – Kidney Disease Program Financial Assistance and Coverage and KDP Reimbursable Services Not Covered by Medicare. She reminded guests to inform patients of the KDP and KDP benefits. She noted that facilities must be certified by the Commission in order for the facility and their patients to receive benefits. The attachments are also posted on the Commission website. Dr. Yospin noted that most of the KDP budget is paid to the dialysis facilities.

B. End of Life Issues for Dialysis Patients

Dr. Segal presented end of life issues and discussed palliative and hospice care for dialysis patients. He noted that future CMS core measures may include hospice and palliative care. Ms. Collins reported that Kaiser offers advanced care planning to members and nonmembers on their website (kp.org).

C. Change in Commission Membership Qualifications for Governor's Appointment Purposes

Mrs. Schwartz reported that legislation has been proposed to remove the restriction for individuals to be appointed to serve on the Commission if they have direct ownership in renal dialysis facilities. She noted that the restriction prevented good candidates from appointment to the Commission as most nephrologists have some ownership in dialysis facilities. Ms. Schwartz stated that the bill would also reduce the minimum number of submitted names required per position from 3 to 2.

D. Network Update

Mrs. Adcock directed the guest attention to the Network Summary Report. The Network provided a summary of their projects, grievance and involuntary discharges.

E. Expanding the Kidney Donor Pool with Hepatitis C Positive Donors Mrs. Adcock directed the guests’ attention to the Expanding the Kidney Donor Pool with Hepatitis C- Positive Donors paper. A recent study lead by Johns Hopkins could increase the availability of organs including kidneys for transplant by transplanting Hepatitis C positive organs into patients who are negative for the virus and treating the recipient for Hepatitis C.

F. Citation Free Surveys

Dr. Yospin commended the follow facilities for achieving citation free surveys:

• Nx Stage West

• JHH Transplant

G. Non- Renewed Facilities

Dr. Yospin reported that the following facilities have elected not to renew their certification:

• FMC S. Annapolis

• FMC Prince George

• FMC Ft. Foote

• FMC Hyattsville

• FMC Orleans Non-certified facilities and their patients are excluded from receiving KDP benefits. A list of certified and uncertified facilities is located on the Commission’s website.

H. Categories of Complaints

Dr. Yospin reported that since the last meeting the Commission has received and resolved the following types of complaints:

Written

• Patient complaint regarding care at a facility

Verbal

1. Physician complaint regarding an abusive patient

2. Patient family member complaint regarding facility placement

3. Patient complaints regarding care at facilities

I. Commission Approval/Disapproval for KDP Out of State Transplant Reimbursement This quarter, the Commission has received and granted 7 out of state transplant prior approvals, for KDP reimbursement purposes.

Hospital – Granted - Refused

MedStar Georgetown Transplant Center 3 0

Christiana Transplant Center 1 0

George Washington University Transplant 2 0

Inova Fairfax Transplant 1 0

J.Surveys

Citations

Compliance with Federal, State and Local Laws and Regulations 0

Infection Control 15

Water and Dialysate Quality 6

Physical Environment 2

Patient Rights 0

Patient Assessment 2

Patient Plans of Care 6

Care at Home 0

Quality Assessment and Performance

Improvement 0

Laboratory/Affiliation Guidelines 0

Personnel Qualifications/Staffing 12

Responsibilities of the Medical Director 0

Medical Records 1

Governance 2

For informational purposes, the Commission shared the results of their survey findings deficiency report for the past quarter. It was noted that infection control and personnel qualifications/staffing continue to be areas that facilities should focus on improving.

K.Surveys Completed

The following 22 facilities have been surveyed since the last meeting:

Davita Cedar Lane, USRC Clinton

Nx Stage West, Davita Cambridge

Davita Easton Advanced Easton

Holy Cross ,ARA Adelphi

Davita Howard County, ARA Ellicott Kidney

FMC Rockville, Deer’s Head

FMC Salisbury, Davita Brandywine

FMC White Marsh, Davita Lakeside

IDF Chestnut, FMC Rosedale

JHH Transplant, Davita Good Samaritan

Davita White Square, Holy Cross Woodmore

There being no further public business, upon motion made by Commissioner Segal and seconded by Commissioner Wise, the Commission unanimously voted to adjourn the Public Session at 3:30 p.m.

https://health.maryland.gov/mdckd/Documents/mins0718.pdf